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1. De Giorgi U, Rosti G, Slavin S, Yaniv I, Harousseau JL, Ladenstein R, Demirer T, Dini G, European Group for Blood and Marrow Transplantation Solid Tumours and Paediatric Disease Working Parties: Salvage high-dose chemotherapy for children with extragonadal germ-cell tumours. Br J Cancer; 2005 Aug 22;93(4):412-7

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  • [Title] Salvage high-dose chemotherapy for children with extragonadal germ-cell tumours.
  • We reviewed the European Group for Blood and Marrow Transplantation (EBMT) experience with salvage high-dose chemotherapy (HDC) in paediatric patients with extragonadal germ-cell tumour (GCT).
  • Of six patients who had a disease recurrence after HDC, one achieved a disease-free status with surgical resection followed by chemotherapy and radiotherapy.
  • HDC induced impressive long-term remissions as salvage treatment in children with extragonadal extracranial GCTs.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Adolescent. Brain Neoplasms / drug therapy. Child. Child, Preschool. Combined Modality Therapy. Databases, Factual. Disease-Free Survival. Female. Hematopoietic Stem Cell Transplantation. Humans. Infant. Male. Mediastinal Neoplasms / drug therapy. Remission Induction. Retroperitoneal Neoplasms / drug therapy. Retrospective Studies. Salvage Therapy

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  • (PMID = 16106248.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2361583
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2. Katz JR, Bareille P, Levitt G, Stanhope R: Growth hormone and segmental growth in survivors of head and neck embryonal rhabdomyosarcoma. Arch Dis Child; 2001 May;84(5):436-9
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  • [Title] Growth hormone and segmental growth in survivors of head and neck embryonal rhabdomyosarcoma.
  • AIMS: To assess the impact of treatment for embryonal rhabdomyosarcoma on spinal growth and limb length and examine the response of these parameters to growth hormone (GH) treatment.
  • All children had been treated with chemotherapy and local radiotherapy.
  • RESULTS: Growth failure secondary to isolated GH deficiency (GHD) developed in 7/17 patients.
  • GHD occurred at a median (range) of 3.4 (1.3-9.9) years after radiotherapy tumour doses of 46 (40-50) Gy.
  • Growth velocity, height, and subischial limb length SDS were significantly reduced in the GHD group and improved with GH therapy.
  • CONCLUSIONS: GH treatment resulted in a significant improvement in sitting height SDS.
  • [MeSH-major] Growth Disorders / drug therapy. Growth Hormone / therapeutic use. Head and Neck Neoplasms / radiotherapy. Rhabdomyosarcoma, Embryonal / radiotherapy
  • [MeSH-minor] Body Height / drug effects. Body Height / radiation effects. Child. Child, Preschool. Female. Follow-Up Studies. Humans. Infant. Leg Bones / growth & development. Leg Bones / radiation effects. Male. Retrospective Studies. Spine / growth & development. Spine / radiation effects. Survivors

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  • (PMID = 11316695.001).
  • [ISSN] 1468-2044
  • [Journal-full-title] Archives of disease in childhood
  • [ISO-abbreviation] Arch. Dis. Child.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 9002-72-6 / Growth Hormone
  • [Other-IDs] NLM/ PMC1718743
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3. Duplan SM, Théorêt Y, Kenigsberg RL: Antitumor activity of fibroblast growth factors (FGFs) for medulloblastoma may correlate with FGF receptor expression and tumor variant. Clin Cancer Res; 2002 Jan;8(1):246-57
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  • [Title] Antitumor activity of fibroblast growth factors (FGFs) for medulloblastoma may correlate with FGF receptor expression and tumor variant.
  • Members of the fibroblast growth factor (FGF) family, which normally control cerebellar neuronal maturation, may represent more natural and less toxic tools with which to target medulloblastoma (MB), an embryonal brain tumor thought to arise from cerebellar neuronal precursors.
  • In support of this, we found previously basic FGF/FGF-2 can inhibit MB progression by inducing neuronal-like differentiation, slowing the growth, and triggering apoptosis of a MB cell line we established from a histopathologically classic tumor (R. L.
  • Consistent with these responses, after FGF treatment, levels of neurofilaments and the proapoptotic modulator Bax only increase in UM-MB1, whereas the cyclin-dependent kinase inhibitor p27/Kip1 (p27), which accumulates in cerebellar neuronal precursors before they exit the cell cycle, goes up in both UM-MB1 and SYR.
  • Finally, although the histological variant of MB may help predict the sensitivity of MB to the FGFs, the selectivity, specificity, and type of response elicited may be dictated by, as evident by immunoprecipitation and Western blot analyses, the expression of certain FGF receptor types.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Brain Neoplasms / drug therapy. Fibroblast Growth Factor 2 / therapeutic use. Fibroblast Growth Factors / therapeutic use. Medulloblastoma / drug therapy. Receptors, Fibroblast Growth Factor / metabolism
  • [MeSH-minor] Animals. Blotting, Western. Cell Differentiation / physiology. Cell Survival. Child, Preschool. Fibroblast Growth Factor 9. Humans. Male. Neurites / drug effects. Precipitin Tests. Proto-Oncogene Proteins / metabolism. Proto-Oncogene Proteins c-bcl-2 / metabolism. Tumor Cells, Cultured / drug effects. Tumor Cells, Cultured / metabolism. bcl-2-Associated X Protein. bcl-X Protein


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4. Sosińska-Mielcarek K, Senkus-Konefka E, Jaskiewicz K, Kordek R, Jassem J: Intraocular malignant teratoid medulloepithelioma in an adult: clinicopathological case report and review of the literature. Acta Ophthalmol Scand; 2006 Apr;84(2):259-62
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  • PURPOSE: To report a case of intraocular medulloepithelioma, an embryonal tumour with extremely rare presentation in adults.
  • RESULTS: The patient presented with progressive proptosis caused by a tumour in the left eyeball.
  • No adjuvant treatment was given.
  • Cisplatin-based chemotherapy was administered, but discontinued after two cycles due to poor tolerance and lack of response.
  • At subsequent pathology review, a final diagnosis of malignant teratoid medulloepithelioma was made.
  • Salvage radiotherapy (60 Gy in 30 fractions) resulted in partial response of the intracranial lesion.
  • However, the patient died 6 months later due to intracranial tumour progression.
  • CONCLUSION: Medulloepithelioma should be considered in the differential diagnosis of intraocular tumours in adults, especially in the case of coexisting, long-standing ocular symptoms.
  • [MeSH-major] Brain Neoplasms / pathology. Eye Neoplasms / pathology. Neuroectodermal Tumors, Primitive / pathology. Orbital Neoplasms / pathology. Teratoma / pathology
  • [MeSH-minor] Adult. Eye Enucleation. Fatal Outcome. Humans. Magnetic Resonance Imaging. Male. Neoplasm Invasiveness. Salvage Therapy

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  • (PMID = 16637848.001).
  • [ISSN] 1395-3907
  • [Journal-full-title] Acta ophthalmologica Scandinavica
  • [ISO-abbreviation] Acta Ophthalmol Scand
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Denmark
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5. Gremmer R, Schröder ML, Ten Huinink WW, Brandsma D, Boogerd W: Successful management of brain metastasis from malignant germ cell tumours with standard induction chemotherapy. J Neurooncol; 2008 Dec;90(3):335-9
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  • [Title] Successful management of brain metastasis from malignant germ cell tumours with standard induction chemotherapy.
  • Because of possible long-term toxicity, cranial radiotherapy (RT) was withheld as part of standard treatment for brain metastasis (BM) from non-seminomatous germ cell tumours (NSGCT).
  • Ten patients presented with BM at initial diagnosis (group 1), two patients developed BM at extra-cranial complete remission (CR) (group 2), and ten patients during treatment of the primary tumour without achieving CR (group 3).
  • All patients received cisplatin-based induction chemotherapy.
  • Five patients received chemotherapy and whole brain RT (WBRT), and five patients received chemotherapy without WBRT.
  • One patient received additional high-dose (HD) chemotherapy with WBRT, and the other HD chemotherapy without WBRT.
  • In group 3, one patient underwent craniotomy, seven patients received WBRT, and four patients additional HD chemotherapy.
  • In group 3, one of ten patients (10%) achieved CR after HD chemotherapy and WBRT (follow-up 107 months).
  • It is concluded that cure in patients with BM from NSGCT can be achieved with standard induction chemotherapy without WBRT.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Brain Neoplasms / drug therapy. Brain Neoplasms / secondary. Cisplatin / therapeutic use. Neoplasms, Germ Cell and Embryonal / pathology

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  • (PMID = 18704268.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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6. Sell S: Alpha-fetoprotein, stem cells and cancer: how study of the production of alpha-fetoprotein during chemical hepatocarcinogenesis led to reaffirmation of the stem cell theory of cancer. Tumour Biol; 2008;29(3):161-80
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  • Identification of the cells in the liver that produce alpha-fetoprotein during development, in response to liver injury and during the early stages of chemical hepatocarcinogenesis led to the conclusion that maturation arrest of liver-determined tissue stem cells was the cellular process that gives rise to hepatocellular carcinomas.
  • When the cellular changes in these processes were compared to that of the formation of teratocarcinomas, the hypothesis arose that all cancers arise from maturation arrest of tissue-determined stem cells.
  • This was essentially a reinterpretation of the embryonal rest theory of cancer whereby tissue stem cells take the role of embryonal rests.
  • A corollary of the stem cell theory of the origin of cancer is that cancers contain the same functional cell populations as normal tissues: stem cells, transit-amplifying cells and mature cells.
  • On the other hand, cancer stem cells generally divide very rarely and contribute little to tumor growth.
  • However, the presence of cancer stem cells in tumors is believed to be responsible for the properties of immortalization, transplantability and resistance to therapy characteristic of cancers.
  • Current therapies for cancer (chemotherapy, radiotherapy, antiangiogenesis and differentiation therapy) are directed against the cancer transit-amplifying cells.
  • When these therapies are discontinued, the cancer reforms from the cancer stem cells.
  • Therapy directed toward interruption of the cell signaling pathways that maintain cancer stem cells could lead to new modalities to the prevention of regrowth of the cancer.

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  • [Copyright] Copyright 2008 S. Karger AG, Basel.
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  • (PMID = 18612221.001).
  • [ISSN] 1423-0380
  • [Journal-full-title] Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine
  • [ISO-abbreviation] Tumour Biol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R01 CA112481-02; United States / NCI NIH HHS / CA / R01 CA071390; United States / NIEHS NIH HHS / ES / R01 ES009495-01A2; United States / NIDDK NIH HHS / DK / R01 DK057619-01A1; United States / NIDDK NIH HHS / DK / R01 DK057619; United States / NIDDK NIH HHS / DK / R01 DK057619-04; United States / NCI NIH HHS / CA / R01 CA074888-01A2; United States / NIEHS NIH HHS / ES / R01 ES009495-03; United States / NCI NIH HHS / CA / R01 CA074888-02; United States / NCI NIH HHS / CA / R01 CA112481-03; United States / NCI NIH HHS / CA / R01 CA071390-04; United States / NIEHS NIH HHS / ES / R01 ES009495-02; United States / NCI NIH HHS / CA / R01 CA112481; United States / NIDDK NIH HHS / DK / R01 DK057619-05; United States / NIDDK NIH HHS / DK / R01 DK057619-02; United States / NCI NIH HHS / CA / R01 CA112481-04; United States / NIEHS NIH HHS / ES / R01 ES009495; United States / NIEHS NIH HHS / ES / R01 ES009495-04; United States / NCI NIH HHS / CA / R01 CA112481-01A1; United States / NCI NIH HHS / CA / R01 CA074888-04; United States / NIEHS NIH HHS / ES / R01 ES009495-05; United States / NCI NIH HHS / CA / R01 CA074888; United States / NCI NIH HHS / CA / R01 CA074888-03; United States / NIDDK NIH HHS / DK / R01 DK057619-03
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / alpha-Fetoproteins
  • [Number-of-references] 188
  • [Other-IDs] NLM/ NIHMS68144; NLM/ PMC2679671
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7. Regueiro CA: [Treatment of intracranial germ cell tumours and other tumours of the pineal region]. Neurocirugia (Astur); 2003 Apr;14(2):127-39
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  • [Title] [Treatment of intracranial germ cell tumours and other tumours of the pineal region].
  • [Transliterated title] Tratamiento de los tumores germinales intracraneales y otros tumores de la región pineal.
  • The management of patients with central nervous system germ-cell tumours is evolving, and a definitive standard has not been achieved.
  • Various prospective trials evaluated the results of combinations of chemotherapy and reduced dose and/or volume radiotherapy.
  • The survival rates of combined treatment approaches were similar to the rates achieved with craniospinal radiotherapy alone.
  • Additional studies are necessary to determine the appropriate radiotherapy volumes and the role of combined treatments.
  • Chemotherapy alone results in high relapse rates and can not be recommended.
  • Non-germinoma germ cell tumours are a heterogeneous group of tumours that includes very aggressive tumours such as mixed and pure choriocarcinomas, yolk sac tumours, and embryonal carcinomas; and tumours with intermediate aggressiveness such as mixed tumours with germinoma and teratoma, immature teratomas and teratomas with malignant transformation.
  • Both radiotherapy alone and chemotherapy alone result in quite low rates of tumour control and current treatment approaches include chemotherapy and radiotherapy, with surgical removal of the tumour in some patients.
  • Current treatment approaches for pineoblastomas include surgery, chemotherapy, and craniospinal irradiation with a local boost.
  • Chemotherapy alone was used to delay irradiation in infants with very little success.
  • [MeSH-major] Brain Neoplasms / radiotherapy. Brain Neoplasms / surgery. Neoplasms, Germ Cell and Embryonal / radiotherapy. Neoplasms, Germ Cell and Embryonal / surgery. Pineal Gland / radiation effects. Pineal Gland / surgery. Pinealoma / radiotherapy. Pinealoma / surgery

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  • (PMID = 12754642.001).
  • [ISSN] 1130-1473
  • [Journal-full-title] Neurocirugía (Asturias, Spain)
  • [ISO-abbreviation] Neurocirugia (Astur)
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Spain
  • [Number-of-references] 98
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8. Berney DM, Shamash J, Gaffney J, Jordan S, Oliver RT: DNA topoisomerase I and II expression in drug resistant germ cell tumours. Br J Cancer; 2002 Sep 9;87(6):624-9
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  • [Title] DNA topoisomerase I and II expression in drug resistant germ cell tumours.
  • A small number of testicular germ cell tumours are refractory to current chemotherapy regimens.
  • DNA topoisomerase I is the target for several new drugs and a potential candidate treatment for chemorefractory germ cell tumours.
  • DNA topoisomerase II alpha is the target for etoposide, which is currently used regularly in germ cell tumour treatment.
  • Pre-chemotherapy orchidectomy specimens were matched with post-chemotherapy retroperitoneal lymph node dissections to examine changes in expression.
  • There was considerable variation in the expression of topoisomerase I in different tumour types.
  • Both yolk sac tumours and teratoma, mature showed universal expression of topoisomerase I, while 38% of seminomas and 30% of embryonal carcinomas were positive.
  • Strong topoisomerase II alpha expression was found in embryonal carcinoma.
  • There was a negative correlation between topoisomerase I and II alpha expression (P=0.004) and downregulation of topoisomerase II alpha after chemotherapy (P=0.02).
  • Topoisomerase I expression appears to increase in those cases with residual teratoma, mature, but is largely unchanged in those cases remaining as embryonal carcinoma.
  • [MeSH-major] Carcinoma, Embryonal / metabolism. DNA Topoisomerases, Type I / metabolism. DNA Topoisomerases, Type II / metabolism. Drug Resistance, Neoplasm. Seminoma / metabolism. Teratoma / metabolism. Testicular Neoplasms / metabolism
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Case-Control Studies. Cisplatin / administration & dosage. Down-Regulation. Etoposide / administration & dosage. Humans. Immunoenzyme Techniques. Ki-67 Antigen / metabolism. Male. Testis / chemistry. Testis / pathology

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  • (PMID = 12237772.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Scotland
  • [Chemical-registry-number] 0 / Ki-67 Antigen; 6PLQ3CP4P3 / Etoposide; EC 5.99.1.2 / DNA Topoisomerases, Type I; EC 5.99.1.3 / DNA Topoisomerases, Type II; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC2364243
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9. Vervenne WL, Bakker PJ, Stalpers LJ, Bosch DA: [Malignant intracranial germ cell tumor treated with chemotherapy and radiotherapy without histopathological confirmation]. Ned Tijdschr Geneeskd; 2000 Mar 11;144(11):527-31
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  • [Title] [Malignant intracranial germ cell tumor treated with chemotherapy and radiotherapy without histopathological confirmation].
  • [Transliterated title] Maligne intracerebrale kiemceltumor behandeld met chemotherapie en radiotherapie zonder histopathologische diagnose.
  • In two men aged 19 and 24 years, a rare malignant intracranial germ cell tumour was diagnosed in the pineal gland region and in the second patient in a suprasellar position as well.
  • The clinical picture of a young patient with an intracerebral tumour localised in the midline of the brain and increased levels of the tumour markers alpha-foetoprotein and/or human chorion gonadotrophin (beta-HCG) in blood and/or CSF makes any other diagnosis highly unlikely.
  • There is no place for radical surgery in the first-line treatment of malignant intracerebral germ cell tumours because of the sensitivity to radio- and chemotherapy.
  • Also, the sensitivity to chemotherapy makes it possible to reduce radiation volume and dose in an effort to avoid the serious complications of craniospinal irradiation.
  • Both patients responded well to chemotherapy based on cisplatin followed by radiotherapy.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Brain Neoplasms / diagnosis. Brain Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / diagnosis. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Chorionic Gonadotropin, beta Subunit, Human / blood. Chorionic Gonadotropin, beta Subunit, Human / cerebrospinal fluid. Diagnosis, Differential. Humans. Magnetic Resonance Imaging. Male. Radiotherapy, Adjuvant. Tomography, X-Ray Computed. Treatment Outcome. alpha-Fetoproteins / cerebrospinal fluid

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  • (PMID = 10735140.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] NETHERLANDS
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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10. Oechsle K, Kollmannsberger C, Honecker F, Boehlke I, Bokemeyer C: Cerebral metastases in non-seminomatous germ cell tumour patients undergoing primary high-dose chemotherapy. Eur J Cancer; 2008 Aug;44(12):1663-9
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  • [Title] Cerebral metastases in non-seminomatous germ cell tumour patients undergoing primary high-dose chemotherapy.
  • BACKGROUND: Retrospective analysis of characteristics and outcome of germ cell tumour (GCT) patients with cerebral metastases (CM) undergoing high-dose chemotherapy (HD-CTX) or relapsing with CM.
  • Forty four percent achieved long-term survival after primary and 16% after salvage treatment (60% in total).
  • Treatment consisted of CTX in 78%, irradiation in 90% and surgery in 63%.
  • CONCLUSION: An interdisciplinary approach of HD-CTX, radiotherapy and surgery leads to long-term survival in 60% of patients with CM at initial diagnosis and 26% relapsing with CM.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Brain Neoplasms. Neoplasms, Germ Cell and Embryonal. Testicular Neoplasms
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Clinical Trials, Phase II as Topic. Combined Modality Therapy / methods. Humans. Lung Neoplasms / secondary. Male. Middle Aged. Multicenter Studies as Topic. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Retrospective Studies. Salvage Therapy / methods. Stem Cell Transplantation. Survival Analysis. Treatment Outcome

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  • [CommentIn] Eur J Cancer. 2008 Aug;44(12):1622-4 [18653329.001]
  • (PMID = 18620855.001).
  • [ISSN] 1879-0852
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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11. Goetz CM, Schmid I, Pietsch T, Peraud A, Haas RJ: Mixed malignant germ cell tumour of the lateral ventricle in an 8-month-old girl: case report and review of the literature. Childs Nerv Syst; 2002 Nov;18(11):644-7
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  • [Title] Mixed malignant germ cell tumour of the lateral ventricle in an 8-month-old girl: case report and review of the literature.
  • CASE REPORT: We report a huge intracerebral malignant germ cell tumour (GCT) which appeared in the lateral ventricles of an 8-month-old girl.
  • Due to extensive tumour vascularisation only partial resection was achieved.
  • Histology revealed an embryonal carcinoma mixed with a teratoma.
  • Chemotherapy induced a marked regression of the tumour.
  • After chemotherapy complete resection of the tumour remnant was easily achieved.
  • Histology showed only mesenchymal differentiated tumour tissue and the embryonal carcinoma could no longer be detected.
  • More than 2 years after the second operation and 31 months after diagnosis the child remains tumour-free.
  • To our knowledge this is the youngest patient in whom an intracranial malignant GCT containing an embryonal carcinoma has been diagnosed and successfully treated.
  • [MeSH-major] Brain Neoplasms / therapy. Lateral Ventricles / pathology. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Combined Modality Therapy. Female. Humans. Infant. Magnetic Resonance Imaging. Neoplasm, Residual. Reoperation. Treatment Outcome

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  • (PMID = 12420127.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 21
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12. Cohn DA, Stuart-Harris R: Isolated central nervous system relapse of non-seminomatous germ cell tumour of the testis. A case report and review of the literature. Oncology; 2001;61(3):184-8
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  • [Title] Isolated central nervous system relapse of non-seminomatous germ cell tumour of the testis. A case report and review of the literature.
  • Isolated central nervous system (CNS) relapse of non-seminomatous germ cell tumour (NSGCT) of the testis has been reported in only 12 patients previously.
  • From a review of previous cases, isolated CNS relapse appears to be more common in patients with embryonal cell histology (alone or mixed with other elements) and occurred after a median of 8.5 months following initial presentation.
  • Long-term survival appears possible using multi-modal treatment with whole-brain radiotherapy, surgery and/or chemotherapy.
  • However, the optimal treatment of isolated CNS relapse remains undefined.
  • [MeSH-major] Brain Neoplasms / secondary. Carcinoma, Embryonal / secondary. Occipital Lobe. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / analysis. Cisplatin / administration & dosage. Combined Modality Therapy. Cranial Irradiation. Etoposide / administration & dosage. Humans. Lung Neoplasms / drug therapy. Lung Neoplasms / secondary. Lymphatic Metastasis. Male. Orchiectomy. Radiotherapy, Adjuvant. Remission Induction. Tomography, X-Ray Computed. Vision Disorders / etiology. alpha-Fetoproteins / analysis

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  • [Copyright] Copyright 2001 S. Karger AG, Basel
  • (PMID = 11574772.001).
  • [ISSN] 0030-2414
  • [Journal-full-title] Oncology
  • [ISO-abbreviation] Oncology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / alpha-Fetoproteins; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 10
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13. La Spina M, Pizzolitto S, Skrap M, Nocerino A, Russo G, Di Cataldo A, Perilongo G: Embryonal tumor with abundant neuropil and true rosettes. A new entity or only variations of a parent neoplasms (PNETs)? This is the dilemma. J Neurooncol; 2006 Jul;78(3):317-20
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  • [Title] Embryonal tumor with abundant neuropil and true rosettes. A new entity or only variations of a parent neoplasms (PNETs)? This is the dilemma.
  • A rare embryonal brain tumor has been diagnosed in a 4-year-old boy.
  • The mass, located at the pons and mesencephalon, has been histologically classified as an embryonal tumor containing abundant neuropil and true rosettes.
  • After surgical complete removal of the neoplasia, the child received intensive combined chemotherapy and radiotherapy.
  • Difficulties in histological definition, possible suggestions for treatment proposals are discussed.
  • [MeSH-major] Brain Neoplasms / pathology. Neuroectodermal Tumors, Primitive / pathology. Neuropil / pathology
  • [MeSH-minor] Child, Preschool. Combined Modality Therapy. Humans. Magnetic Resonance Imaging. Male. Mesencephalon / pathology. Pons / pathology. Treatment Outcome

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  • (PMID = 16598427.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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14. Johnston DL, Keene D, Bartels U, Carret AS, Crooks B, Eisenstat D, Fryer C, Lafay-Cousin L, Larouche V, Moghrabi A, Wilson B, Zelcer S, Silva M, Brossard J, Bouffet E: Patterns of enrollment of infants with central nervous system tumours on cooperative group studies: a report from the Canadian Pediatric Brain Tumour Consortium. J Neurooncol; 2010 Sep;99(2):243-9
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  • [Title] Patterns of enrollment of infants with central nervous system tumours on cooperative group studies: a report from the Canadian Pediatric Brain Tumour Consortium.
  • In children under the age of 3, the most common solid tumours are brain tumors.
  • Treatment for many of these patients includes surgery, chemotherapy and rarely radiation therapy.
  • Many clinical trials have been performed in an attempt to establish the best treatment for these patients.
  • Patients enrolled on clinical trials contribute to the establishment of the best therapy.
  • We performed a national survey of all children less than the age of three with brain tumours and examined the contribution these patients made to clinical trials.
  • A data bank was established using data collected from Canadian pediatric oncology centers on children less than age 3 diagnosed with brain tumours between 1990 and 2005.
  • Data were collected on the use of adjunctive treatment after surgery, treatment on a protocol, reasons patients were not registered on a protocol, and reasons for discontinuation of therapy.
  • From the 579 cases in the data bank, 302 (52%) patients were treated with further therapy after surgery.
  • The use of further therapy after surgery was significantly higher in patients with cerebellar and brain stem tumors, patients who were over 1 year of age, patients with ependymal and embryonal tumors, and patients with high grade malignant tumors.
  • Only 62 (21%) patients were enrolled on a protocol for therapy.
  • The therapy was stopped because of completion of the protocol in 50% and because of disease progression in 34%.
  • In Canada, about half of children under the age of 36 months with brain tumors are undergoing therapy following surgery for their malignancy but only a small fraction of them are enrolled on a clinical trial.
  • There needs to be improved availability of clinical trials for these patients so that novel therapies can be evaluated and survival improved.
  • [MeSH-major] Brain Neoplasms / epidemiology. Child Health Services / utilization. Glioma / epidemiology. Patient Participation. Patient Selection
  • [MeSH-minor] Canada / epidemiology. Child, Preschool. Combined Modality Therapy. Female. Humans. Infant. Infant, Newborn. Male. Neoplasm Staging. Survival Rate. Treatment Outcome

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  • (PMID = 20135195.001).
  • [ISSN] 1573-7373
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Taylor RE: United Kingdom Children's Cancer Study Group (UKCCSG) radiotherapy and brain tumour groups: medulloblastoma/PNET and craniospinal radiotherapy (CSRT): report of a workshop held in Leeds, 30 June 1999. Clin Oncol (R Coll Radiol); 2001;13(1):58-64
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  • [Title] United Kingdom Children's Cancer Study Group (UKCCSG) radiotherapy and brain tumour groups: medulloblastoma/PNET and craniospinal radiotherapy (CSRT): report of a workshop held in Leeds, 30 June 1999.
  • Primitive neuroectodermal tumours (PNET), of which cerebellar medulloblastoma is the most frequent, are embryonal central nervous system tumours arising mainly in children.
  • In the last 25 years, European and North American collaborative studies have investigated the role of adjuvant chemotherapy.
  • [MeSH-minor] Brain. Child. Clinical Trials as Topic. Dose Fractionation. Humans. Multicenter Studies as Topic. Prognosis. Quality Assurance, Health Care. Spinal Cord

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  • (PMID = 11292140.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Congresses; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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16. Brandes AA, Pasetto LM, Monfardini S: The treatment of cranial germ cell tumours. Cancer Treat Rev; 2000 Aug;26(4):233-42
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  • [Title] The treatment of cranial germ cell tumours.
  • Germ cell tumours of the central nervous system (CNS) include many subtypes whose response to treatment varies, even though the symptoms and radiological appearances are similar.
  • Patients with choriocarcinoma, embryonal carcinoma, or yolk sac tumour have the lowest survival rates; patients with germinoma or mature teratoma have longer survival rates.
  • Beside the delayed injury induced by radiotherapy, the late injury induced by chemotherapy is becoming increasingly evident.
  • Cisplatin is considered an indispensable drug, but it may cause renal damage, ototoxicity, peripheral neuropathy and sterility, while etoposide is associated with an excess frequency of second neoplasms.
  • Taking into account all of the published literature, the following therapeutic options are suggested: in pure germinoma tumours (GT) radiotherapy alone will usually ensure adequate control of the disease, and the long-term sequelae may be limited by reducing the dose delivered, as was proposed for germ cell testicular tumours, to 30 Gy to limited fields plus 25-30 Gy to the spinal axis if there is disseminated disease.
  • In cases of recurrence, which should be uncommon, patients may be rescued with both radiotherapy and chemotherapy.
  • In NGGC tumours, the prognosis is more unfavourable and there is often dissemination to the spine at diagnosis; however, the tumour's high chemosensitivity suggests neoadjuvant treatment chemotherapy with cisplatin and etoposide for three cycles followed by consolidation radiotherapy with 40 Gy to the limited fields plus 30 Gy to the spinal axis if disseminated.
  • In our opinion, a higher dose of radiotherapy in cases in which chemotherapy does not achieve a radiological complete remission is not advisable, because very often the residual radiological abnormality does not represent biologically active tumour but differentiated forms such as mature teratoma.
  • The challenge for 2000 is to both cure these patients, and avoid the late and permanent sequelae of radiation and/or chemotherapy that may subsequently impair quality of life.
  • [MeSH-major] Brain Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Combined Modality Therapy. Cranial Irradiation. Drug Therapy. Humans. Neurosurgical Procedures. Prognosis. Radiotherapy Dosage. Survival Rate

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  • [Copyright] Copyright 2000 Harcourt Publishers Ltd.
  • (PMID = 10913379.001).
  • [ISSN] 0305-7372
  • [Journal-full-title] Cancer treatment reviews
  • [ISO-abbreviation] Cancer Treat. Rev.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] ENGLAND
  • [Number-of-references] 59
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17. Suzuki S, Nishio S, Takata K, Morioka T, Fukui M: Radiation-induced brain calcification: paradoxical high signal intensity in T1-weighted MR images. Acta Neurochir (Wien); 2000;142(7):801-4
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  • [Title] Radiation-induced brain calcification: paradoxical high signal intensity in T1-weighted MR images.
  • However, we have studied three patients with radiation-induced brain calcification, who manifested increased signal intensity on T1-weighted MR images.
  • METHOD: Three girls had each been diagnosed as having a suprasellar germ cell tumour and were treated with conventional fractionated radiotherapy in their childhood.
  • In one case, chemotherapy was given prior to the CNS irradiation.
  • FINDINGS: All three patients survived their disease, and a follow-up CT scan revealed calcification in the brain, which has shown an increased signal intensity in the T1-weighted images of MR.
  • This may be explained by a surface-relaxation effect by the calcium salt particle, precipitated in the brain due to radiation-induced mineralising microangiopathy.
  • [MeSH-major] Brain Diseases / etiology. Brain Neoplasms / radiotherapy. Calcinosis / etiology. Neoplasms, Germ Cell and Embryonal / radiotherapy. Radiation Injuries / etiology. Radiotherapy / adverse effects


18. Kon H, Kumabe T, Jokura H, Shirane R: Recurrent intracranial germinoma outside the initial radiation field with progressive malignant transformation. Acta Neurochir (Wien); 2002 Jun;144(6):611-6
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  • A 19-year-old man with a pure germinoma in the pineal region was successfully treated with chemotherapy followed by 24 Gy local irradiation.
  • Near complete response was achieved again after 28.8 Gy whole brain and 24 Gy whole spine irradiation.
  • Gamma knife radiosurgery did not control this mass, so tumour resection was performed.
  • Enlargement of the recurrent mass at the trigone of the left lateral ventricle was found in spite of additional chemotherapy.
  • Tumour extirpation was performed and histological examination revealed embryonal carcinoma.
  • The patient died of tumour progression 34 months after the initial treatment.
  • By a combination of chemotherapy regiments in use today, the initial radiation field to treat intracranial germinomas should not be confined to the tumour bed.
  • [MeSH-major] Brain Neoplasms / drug therapy. Brain Neoplasms / radiotherapy. Germinoma / drug therapy. Germinoma / radiotherapy. Neoplasm Recurrence, Local. Pineal Gland / pathology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cell Transformation, Neoplastic. Combined Modality Therapy. Disease Progression. Humans. Magnetic Resonance Imaging. Male. Radiosurgery

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  • (PMID = 12111494.001).
  • [ISSN] 0001-6268
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Austria
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19. Mickisch GH: Prognostic parameters for the management of advanced testis tumours. Curr Opin Urol; 2000 Sep;10(5):465-71
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  • The need for prognostic parameters in testicular germ cell tumours is sometimes questioned based on an overall cure rate of more than 80% of the patients regardless of tumour stage.
  • However, the trend for an earlier and more accurate diagnosis amenable to curative treatment as well as the high effectiveness of standard Cisplatinum containing chemotherapy has masked the continuing need for intensifying therapy in patients with adverse risk factors.
  • This intense treatment is often associated with worrysome morbidity and the assessment of prognostic factors, stage by stage, is warranted on which patient at risk can be identified and treated accordingly.
  • Traditional prognostic factors, on which most classification systems are based, include large tumour volume, the presence of liver, bone or brain metastasis, grossly elevated tumour markers and an extragonadal primary site, particularly in the mediastinum.
  • Novel prognostic factors are either (1) independent from the patient and his disease, (2) inherent on the patient's characteristics or (3) based on tumour biology.
  • Clearly, the infrastructure and the experience of the treating uro-oncology unit (see 1) is decisive for treatment outcomes, and -at least-'difficult to treat' patients should be referred to properly resourced cancer centres.
  • Finally, biologic factors (see 3) such as beta-human chorionic gonadotrophin or MAGE epitopes in seminoma or the percentage of embryonal carcinoma components orvascular invasion mayor may not inversely influence the prognosis and need further assessment in prospective trials.
  • However, the search for even better (molecular) biologic factors is speeding up because more complex treatment decisions such as in advanced testicular cancers rely on a more precise determination of prognosis, enabling a more tailored selection of individualized therapeutic options.
  • [MeSH-major] Biomarkers, Tumor / analysis. Neoplasms, Germ Cell and Embryonal / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Disease Progression. Health Services Accessibility. Humans. Male. Neoplasm Staging / methods. Prognosis. Risk Factors. Social Class

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  • (PMID = 11005453.001).
  • [ISSN] 0963-0643
  • [Journal-full-title] Current opinion in urology
  • [ISO-abbreviation] Curr Opin Urol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 23
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20. Sloetjes KG, van den Bergh JP, Wesseling P, Otten BJ, Pieters GF, Hermus AR: [Clinical presentation, treatment, and follow-up of 32 patients with a primary intracranial germinoma, registered during the previous 15 years in the Dutch Pathological-Anatomical National Automated Archive (PALGA)]. Ned Tijdschr Geneeskd; 2000 Nov 18;144(47):2264-8
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  • [Title] [Clinical presentation, treatment, and follow-up of 32 patients with a primary intracranial germinoma, registered during the previous 15 years in the Dutch Pathological-Anatomical National Automated Archive (PALGA)].
  • [Transliterated title] Kliniek, behandeling en follow-up van 32 patiënten met een primair intracranieel germinoom uit de afgelopen 15 jaar, geregistreerd in het Pathologisch-Anatomisch Landelijk Geautomatiseerd Archief (PALGA).
  • OBJECTIVE: Evaluation of clinical presentation, treatment and follow-up of patients with intracranial germinoma in the Netherlands.
  • Informed consent was obtained from 32 of the 44 patients with respect to studying their medical records for age, symptoms at presentation, diagnostic investigations, presence of tumour markers, treatment and follow up.
  • RESULTS: The patient group consisted of 23 men and 9 women aged 6 to 35.6 years (mean: 17.3) and was subdivided with respect to their tumour localization.
  • Thirty-one patients were treated with radiotherapy, one with combined radiotherapy and chemotherapy and one surgically.
  • One patient developed an intracranial embryonal carcinoma and another a testis seminoma.
  • CONCLUSION: At the time of this study 84% of all patients treated with radiotherapy were disease-free.
  • Although the percentage patients who had recovered after treatment (surgical and radiotherapy) was high, many patients either already had or subsequently developed neurological and endocrinological deficiencies.
  • [MeSH-major] Brain Neoplasms / diagnosis. Brain Neoplasms / therapy. Germinoma / diagnosis. Germinoma / therapy
  • [MeSH-minor] Adolescent. Adult. Cause of Death. Child. Diagnosis, Differential. Disease-Free Survival. Endocrine System Diseases / etiology. Female. Humans. Intracranial Hypertension / etiology. Male. Neoplasms, Germ Cell and Embryonal / etiology. Netherlands. Ocular Motility Disorders / etiology. Recurrence. Registries. Retrospective Studies. Treatment Outcome

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  • (PMID = 11109472.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] NETHERLANDS
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21. Schwarz AJ, Maisey NR, Collins DJ, Cunningham D, Huddart R, Leach MO: Early in vivo detection of metabolic response: a pilot study of 1H MR spectroscopy in extracranial lymphoma and germ cell tumours. Br J Radiol; 2002 Dec;75(900):959-66
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  • [Title] Early in vivo detection of metabolic response: a pilot study of 1H MR spectroscopy in extracranial lymphoma and germ cell tumours.
  • Monitoring therapeutic efficacy is essential in oncological practice.
  • We have investigated the feasibility of using proton (1)H MR spectroscopy (MRS), localized to malignant lymphoma and germ cell lesions outside the cranial cavity, to monitor tumour metabolism in vivo during chemotherapy treatment. (1)H single voxel MRS, (stimulated echo acquisition mode, repetition time/echo time=2000/20 ms) was performed prior to treatment in patients with lymphoma or germ cell tumours, and during the first cycle of chemotherapy.
  • Patient response was assessed by independent clinical follow-up at a median of 57 days (range 44-93 days) post-treatment.
  • All 12 non-cystic lesions scanned showed a signal assigned to choline-containing metabolites (tCho); 9 were scanned both pre- and post-treatment.
  • Changes in the tCho:water ratio following treatment were found to predict subsequent patient response.
  • In seven of these nine patients, the tCho:water ratio decreased in the first post-treatment scan, and all subsequently achieved a partial response to treatment.
  • In the remaining two patients, both of whom progressed on treatment, the tCho:water ratio did not change significantly.
  • Normalized to pre-treatment values, the non-responder group values (1.07 and 0.97) were clearly distinct from the responder group, whose values ranged from 0.43 to below detection level.
  • To our knowledge, this is the first report of (1)H MR spectra from these tumour types and sites.
  • These preliminary results indicate that metabolite signals can be detected using (1)H MRS in these tumour types and locations, as has already been established in the brain, breast and prostate.
  • Moreover, the differential changes observed in the tCho region of the spectrum suggest that (1)H MRS could provide an early and sensitive indicator of metabolic response to chemotherapy.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Drug Monitoring / methods. Lymphoma / drug therapy. Magnetic Resonance Spectroscopy / methods. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Choline / metabolism. Feasibility Studies. Follow-Up Studies. Humans. Middle Aged. Pilot Projects. Treatment Outcome

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  • (PMID = 12515704.001).
  • [ISSN] 0007-1285
  • [Journal-full-title] The British journal of radiology
  • [ISO-abbreviation] Br J Radiol
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / UO1 CA62557-02
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; N91BDP6H0X / Choline
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22. Kellie SJ, Chaku J, Lockwood LR, O'Regan P, Waters KD, Wong CK, Australian and New Zealand Children's Haematology Oncology Group: Late magnetic resonance imaging features of leukoencephalopathy in children with central nervous system tumours following high-dose methotrexate and neuraxis radiation therapy. Eur J Cancer; 2005 Jul;41(11):1588-96
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  • [Title] Late magnetic resonance imaging features of leukoencephalopathy in children with central nervous system tumours following high-dose methotrexate and neuraxis radiation therapy.
  • This report describes the National Cancer Institute (NCI) toxicity grade of leukoencephalopathy based on magnetic resonance imaging (MRI) findings in all patients who survived 4 or more years after treatment on an earlier phase II study.
  • These patients, with newly diagnosed CNS embryonal tumours, were in the age range 3.5-14.2 years (median 6.9 years) at diagnosis, and received four courses of pre-irradiation combination chemotherapy, including HDMTX 8 g/m(2).
  • Following completion of the 'up-front' phase II study, all patients received conventionally fractionated whole brain doses of 36-50.4 Gy.
  • The radiation dose and treatment volumes were determined individually according to the primary tumour location and results of extent of disease evaluations.
  • The most recent MRI brain scans, obtained 4.0-10.5 years (median 6.5 years) after radiation therapy and comprising a minimum of T1, T1 following gadolinium and T2 sequences, were reviewed centrally to assess the neuroradiological grade of leukoencephalopathy, based on the NCI Common Terminology Criteria for Adverse Events, v3.0.
  • In conclusion, treatment with multiple courses of HDMTX prior to 36-50.4 Gy cranial radiation did not result in moderate to severe MRI features of leukoencephalopathy.
  • [MeSH-major] Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cerebellar Neoplasms / pathology. Dementia, Vascular / pathology. Medulloblastoma / pathology. Methotrexate / administration & dosage
  • [MeSH-minor] Adolescent. Carboplatin / administration & dosage. Child. Child, Preschool. Combined Modality Therapy / methods. Etoposide / administration & dosage. Humans. Infant. Magnetic Resonance Imaging

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  • (PMID = 16026694.001).
  • [ISSN] 0959-8049
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; YL5FZ2Y5U1 / Methotrexate
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